Term
| What are features of nerve pain? |
|
Definition
-sharp
-burning
-numb
-tingling (follow nerve) |
|
|
Term
| What are features of bone pain? |
|
Definition
-deep
-boring
-well-localized |
|
|
Term
| What are features of muscle pain? |
|
Definition
-dull
-aching
-hard to localize
-increased with movement |
|
|
Term
| What are features of vascular pain? |
|
Definition
-diffuse
-aching
-poorly localized |
|
|
Term
| Where does a sprain occur? |
|
Definition
|
|
Term
| Where does a strain occur? |
|
Definition
|
|
Term
| Where does effusion occur? |
|
Definition
|
|
Term
| What is a Grade I sprain? |
|
Definition
-stretching of tissue
-no joint instability |
|
|
Term
| What are features of Grade II sprain? |
|
Definition
-partial tearing of tissue
-more bruising
-laxity but definite end-point |
|
|
Term
| What are features of Grade III sprain? |
|
Definition
-significant tearing
-deformity
-swelling
-no definite end-point when stressed |
|
|
Term
| What are features of Grade I strain? |
|
Definition
-minor degree of microscopic tearing
-no permanent defect |
|
|
Term
| What are features of Grade II tearing? |
|
Definition
-incomplete disruption of muscle fibers
-some loss of muscle function
- |
|
|
Term
| Clinically, Grade I and II strains can be indistinguishable. T/F |
|
Definition
|
|
Term
| What are features of Grade III strains? |
|
Definition
-complete rupture of muscle
-nearly complete or complete loss of muscle function
-usually associated with retraction, spasm, and shortening |
|
|
Term
| Arm length discrepancies are ___?___ common than leg length discrepancies. |
|
Definition
|
|
Term
| Knee, hip, and low back pain may be related to ___?___ |
|
Definition
|
|
Term
| What are the anatomical points of the arm? |
|
Definition
-acromion
-olecranon
-distal ulnar styloid |
|
|
Term
| What are the anatomical points of the leg? |
|
Definition
-anterior superior iliac spine (ASIS)
-medial malleolus |
|
|
Term
| Painful arc (pain bw 45/60 and 120 degrees) indicates ___?___ |
|
Definition
|
|
Term
| What are the 3 tests for rotator cuff tears? |
|
Definition
-supraspinatus weakness
-weakness in external rotation
-impingement in external or internal rotation or both |
|
|
Term
|
Definition
-arm fully pronated and placed in forced flexion
-pain indicates subacromial impingement |
|
|
Term
|
Definition
-elevate arm forward to 90 degrees, bend at elbow, forcefully internally rotate arm
-pain indicates subacromial impingement |
|
|
Term
| Passive extension of shoulder may improve palpation of ___?___ anterior to acromion. |
|
Definition
|
|
Term
| Adhesive capsulitis has pain with ___?___ ROM. |
|
Definition
|
|
Term
| The deltoid is responsible for the 1st ___?___ degrees of abduction. |
|
Definition
|
|
Term
| What is a common name for adhesive capsulitis? |
|
Definition
|
|
Term
| What occurs in biceps tendinitis? |
|
Definition
| long head of biceps passes underneath acromion, enters groove bw greater and lesser tuberosities |
|
|
Term
| Shoulder instability peaks in the ___?___ and ___?___ decades of life, and recurrence is inversely related to age. |
|
Definition
|
|
Term
| ___?___ is the major cause of shoulder instability, according to AAOS. |
|
Definition
|
|
Term
| The most common type of shoulder instability is ___?___ and is due to ____?___. |
|
Definition
|
|
Term
| The deltoid muscle's major function is to ___?___. |
|
Definition
|
|
Term
| How is the sulcus sign elicited? |
|
Definition
-pt sitting or standing
-grab arm just above elbow
-watch lateral border of acromion
-pull arm downward
-feel a "suction cup" where the humeral head pulls out of the glenoid |
|
|
Term
| What does the sulcus sign indicate? |
|
Definition
|
|
Term
| What types of shoulder instability can have voluntary dislocation? |
|
Definition
| -posterior and multidirectional |
|
|
Term
| What are causes of multidirectional instability? |
|
Definition
-repetitive microtrauma (gymnastics, butterfly stroke)
-aberrant muscle firing
-abnormal connective tissue |
|
|
Term
| There are 6 grades of acromioclavicular joint separation; need to see a specialist after grade ___?___ |
|
Definition
|
|
Term
| Acromioclavicular joint separations occur most often in ___?___ |
|
Definition
|
|
Term
| Radial head fractures usually require surgery. T/F |
|
Definition
| false: usually nonsurgical treatment and mobilization is key |
|
|
Term
| What is the fat pad sign in elbow fractures? |
|
Definition
-displacement of normal fat pad by fluid (blood, effusion) in joint
-aka sail sign, bc triangle sail shape |
|
|
Term
| A positive fat pad sign is a more reliable indicator of elbow fracture in children than adults. T/F |
|
Definition
|
|
Term
| What is a common name of lateral epicondylopathy? |
|
Definition
|
|
Term
| Lateral epicondylopathy involves ___?___ of the common extensor tendon and extensor carpi radialis brevis. |
|
Definition
|
|
Term
| What are findings in the exam of lateral epicondylopathy? |
|
Definition
-swelling
-erythema
-increased pain with resisted wrist extension and supination |
|
|
Term
| What are the bones of the hand? |
|
Definition
Scaphoid
Lunate
Triquetral
Pisiform
Hamate
Capitate
Trapezoid
Trapezium |
|
|
Term
| What are signs of scaphoid fracture? |
|
Definition
pain:
-in anatomic snuffbox
-in scaphoid tuberosity
-with resisted pronation |
|
|
Term
| ___?___ is the most commonly fractured carpal bone. |
|
Definition
|
|
Term
| What is the clinical appearance of wrist fractures? |
|
Definition
-point tenderness
-dinner fork deformity |
|
|
Term
|
Definition
-aka dinner fork or bayonet deformity
-fracture of the distal radius of the forearm
-dorsal (posterior) displacement of the wrist and hand |
|
|
Term
| What is De Quervain's tenosynovitis? |
|
Definition
-aka stenosing
-inflammation of 2 tendons: APL and EPB |
|
|
Term
| ___?___ confirms the diagnosis of De Quervain's Tenosynovitis? |
|
Definition
|
|
Term
| What is Finkelstein's Test? |
|
Definition
-grasp thumb
-sharply ulnar deviate
-positive: sharp pain along distal radius |
|
|
Term
|
Definition
-thumb in palm
-fold over fingers
-ulnar deviate
-positive: sharp pain along distal radius indicates De Quervain's Tenosynovitis |
|
|
Term
| ___?___ is the most common entrapment neuropathy and is idiopathic in 95% of cases? |
|
Definition
|
|
Term
| What is the etiology of carpal tunnel syndrome? |
|
Definition
| median nerve compressed at the wrist, resulting in numbness or pain |
|
|
Term
| What are signs of and tests for carpal tunnel syndrome? |
|
Definition
-thenar wasting
-Tinel's test: tap wrist
-Phalen's test: backs of hands together |
|
|
Term
| The PIP joint the strongest ligament is the ___?___. It connects the proximal to the middle phalanx and prevents the joint from hyperextending. |
|
Definition
|
|
Term
| Mallet finger is a ___?___ deformity of the finger. |
|
Definition
|
|
Term
| Why must hip fracture be treated expeditiously in young patients? |
|
Definition
| prevent vessel compromise, clear fracture hematoma that may reduce blood flow to femoral head |
|
|
Term
| What hip fracture treatment is favored in the elderly d/t difficulty achieving stable fixation in osteopenic/osteoporotic bone? |
|
Definition
|
|
Term
| What sex and age group are most affected by avascular necrosis/osteonecrosis? |
|
Definition
-male
-late 30s to early 40s |
|
|
Term
| ___?___% of hip fracture cases are idiopathic; ___?___% are associated with trauma. |
|
Definition
|
|
Term
| What factors increase the risk of hip fracture? |
|
Definition
-corticosteroid use
-ETOH abuse
-hypercoagulable states
-HIV |
|
|
Term
| What are features of sciatica? |
|
Definition
-a symptom, not a dx
-pain in lower back, buttocks, leg, foot
-numbness
-muscular weakness
-difficulty in moving and controlling leg
-unilateral |
|
|
Term
| What is piriformis syndrome? |
|
Definition
| sciatic nerve entrapped in piriformis muscle |
|
|
Term
| Which is weaker and is more commonly injured: MCL or LCL? |
|
Definition
|
|
Term
| Valgus stress causes ___?___ and varus stress causes ___?___. |
|
Definition
|
|
Term
| What causes ACL injuries? |
|
Definition
-hyperextension
-sudden deceleration
-impact
-valgus
-external rotation
-anterior femoral displacement forces |
|
|
Term
| What causes PCL injuries? |
|
Definition
-forced hyperextension
-direct blow to anterior tibia |
|
|
Term
| Contact injuries are common causes of ___?___ injury; non-contact injuries are common causes of ___?___. |
|
Definition
-contact: MCL
-non-contact: ACL |
|
|
Term
| Which sex has 2-4 fold increase in ACL injuries when playing sports at the same level? |
|
Definition
|
|
Term
| MRI is a reliable way to confirm ACL tear. T/F |
|
Definition
| false- exam is mainstay of diagnosis |
|
|
Term
| What tests are used to diagnose ACL tear? |
|
Definition
-Lachman's test
-anterior drawer test: nost as sensitive, but easier to perform |
|
|
Term
| How is Lachman's test performed? |
|
Definition
-pt's knee flexed to 30 degrees
-hand anterior on thigh, posterior on tibia, thumb on tibial tuberosity
-pull tibia anterior
-an ACL deficient knee will have increased forward movement |
|
|
Term
| How is the anterior drawer test performed? |
|
Definition
-pt hip flexed 45, knee 90
-grasp tibia below knee, thumbs on either side of patellar tendon, index fingers on hamstring tendons
-tibia drawn forward anteriorly
-an ACL deficient knee will have increased forward movement |
|
|
Term
| What does the PCL prevent? |
|
Definition
| posterior translation of the tibia |
|
|
Term
| What test is used to diagnose PCL tear? |
|
Definition
|
|
Term
| How is the posterior drawer test performed? |
|
Definition
-pt hip flexed 45, knee 90
-grasp tibia below knee, thumbs on either side of patellar tendon, index fingers on hamstring tendons
-tibia pushed posteriorly
-an ACL deficient knee will have increased backward movement |
|
|
Term
| ___?___ mm of posterior laxity is well-tolerated. |
|
Definition
|
|
Term
| What is the primary function of the meniscus? |
|
Definition
| evenly distribute weight-bearing load across the knee joing |
|
|
Term
| What causes and exacerbates meniscus tears? |
|
Definition
-twisting injury
-descending stairs, entering/exiting vehicles |
|
|
Term
| What are symptoms of meniscus tear? |
|
Definition
-effusion
-tibial joint line pain (often medial) |
|
|
Term
| What tests are used for a torn meniscus? |
|
Definition
|
|
Term
| How is McMurray's test performed? |
|
Definition
| internally/externally rotate tibia while extending knee |
|
|
Term
| How is Steinmann's test performed? |
|
Definition
| suddenly twist flexed knee |
|
|
Term
| Which meniscal tears can be treated nonsurgically? |
|
Definition
-stable longitudinal tears
-stable partial tears
-shallow radial tears |
|
|
Term
| What sex and age group usually suffers from patellofemoral pain? |
|
Definition
-female
-adolescent, young adult |
|
|
Term
| What are signs of patellofemoral syndrome? |
|
Definition
-malalignment
-quadriceps imbalance |
|
|
Term
| What are non-operative treatments for quad strengthening in patellofemoral syndrome? |
|
Definition
-short-arc extensions
-patellar bracing |
|
|
Term
| Suprapatellar bursa communicates with knee joint, while others are extraarticular. T/F |
|
Definition
|
|
Term
| What is a differential diagnosis for septic bursitis? |
|
Definition
|
|
Term
| What are Ottawa Ankle Rules used for? |
|
Definition
| -ruling out fracture and need for x-rays |
|
|
Term
| What type of ankle sprain is responsible for 80-85%? |
|
Definition
|
|
Term
| What test is used to identify a sprain of the anterior talofibular ligament? |
|
Definition
|
|
Term
| What test is used to identify a sprain of the calcaneofibular ligament? |
|
Definition
|
|
Term
| How is the talar tilt test performed? |
|
Definition
| adduct and invert the calcaneous into a varus position |
|
|
Term
| Ankle ligaments are most often injured in ___?___ order. |
|
Definition
|
|
Term
| What type of ankle sprain is responsible for 10-15%? Why more rare? |
|
Definition
-deltoid sprain
-requires more force |
|
|
Term
| What is the function of the deltoid ligament? |
|
Definition
-strengthen the joint
-hold the calcaneus and navicular bones against the talus
-maintain the medial longitudinal arch of the foot
- |
|
|
Term
| What x-ray views are needed for ankle pain? |
|
Definition
|
|
Term
| Fractures at or above the talar dome are more likely to cause a shift in mortise joint. T/F |
|
Definition
|
|
Term
| What activities are commonly involved in tendonitis/tendinosis? |
|
Definition
|
|
Term
| Who is more likely to have Achilles tendon rupture? |
|
Definition
-recreational athlete
-relatively older, 30-50 years old
-previous Achilles tendon or rupture
-previous tendon injections
-previous fluoroquinolone use |
|
|
Term
| What test is used for Achilles tendon rupture? |
|
Definition
|
|
Term
| How is the Thompson test performed? |
|
Definition
-pt prone
-squeeze calf
-normal: slight plantarflexion, positive: lack of ankle movement |
|
|
Term
| What are features of peroneal tendonitis? |
|
Definition
-common in lateral sprain and fracture
-chronic pain post-sprain
-lateral ankle and foot pain
-resisted external rotation of foot
-subluxation of tendons |
|
|
Term
| What is a Lisfranc injury? |
|
Definition
-tearing of inter-metatarsal ligaments
-1 or all of metatarsals displaced for tarsus |
|
|
Term
| The ___?___ area is most often affected by Morton's neuroma. |
|
Definition
| 3rd and 4th interdigital area |
|
|
Term
| What are symptoms of Morton's neuroma? |
|
Definition
-numbness
-tingling
-exacerbated by tight footwear, compression of metatarsal heads |
|
|
Term
| What are causes of metatarsalgia? |
|
Definition
-synovitis
-ligament damage
-bunions
-arthritis
-repetitive high pressure loading of forefoot
-improper footwear
-high heels |
|
|
Term
| What are treatment options for metatarsalgia? |
|
Definition
-RICE
-non-weight-bearing ambulation for 1st 24 hours
-passive ROM
-ultrasound tx
-metatarsal pads
-orthotic devices |
|
|
Term
| Point tenderness is more indicative of a fracture. T/F |
|
Definition
|
|
Term
| Why are buckle fractures only seen in children? |
|
Definition
| -periosteum thicker (~ snapping a pencil from within a straw) |
|
|
Term
| Why are spiral fractures indicative of child abuse? |
|
Definition
| uncommon for a child to have enough force to create |
|
|
Term
| The shoulder is a ___?___ joint held by tendons. |
|
Definition
|
|
Term
| ___?___% of rotator cuff injuries don't require surgery. |
|
Definition
|
|
Term
| What type of person is adhesive capsulitis usually seen in? |
|
Definition
-female
- > 40 years old
-DM |
|
|
Term
| Adhesive capsulitis usually presents gradually. T/F |
|
Definition
| false- usually presents gradually |
|
|
Term
| Anterior fat pad sign is more clinically significant than posterior. T/F |
|
Definition
| false- posterior more significant |
|
|
